Pancreatic cancer, although an uncommon tumor, is one of the most lethal tumors. The incidence of pancreatic cancer in Korea has increased over the past 15 years, with about 3, 000 cases annually. It appears to correlate with increasing age, and it is slightly more common among men. Because of high mortality rate, pancreatic cancer now rank fourth as a cause of death from cancer in Korea. Some diseases and medical conditions such as diabetes, chronic pancreatitis, as well as environmental and lifestyle risk factors, and occupational and genetic conditions. may play important role in the etiology of pancreatic cancer. The most consistently identified environmental risk factor is smoking, but there is less certainty concerning dietary factors. Studies have suggested a positive association with high energy intake, cholesterol and meat, while vegetable and fruit intakes are probably protective. Patients with chronic pancreatitis and new onset of diabetes mellitus have a low but increasing risk of having or developing pancreatic cancer. A family history of pancreatic cancer is an important risk factor, but only a small proportion can be linked with known familial cancer syndromes. Until the development of new methods for early diagnosis and better modalities for therapeutic intervention, primary prevention is the most effective approach to reduce the incidence of pancreatic cancer.
Carcinoma, Pancreatic Ductal ; Cause of Death ; Cholesterol ; Diabetes Mellitus ; Early Diagnosis ; Energy Intake ; Epidemiology* ; Fruit ; Humans ; Incidence ; Korea ; Life Style ; Male ; Meat ; Mortality ; Pancreatic Neoplasms* ; Pancreatitis, Chronic ; Primary Prevention ; Risk Factors* ; Smoke ; Smoking ; Vegetables

BACKGROUND/AIMS: Since pancreatic endocrine tumors (PET) are rare and heterogeneous diseases, their survival and prognosis are not well known. Due to recent advances in CT/MRI technology, incidentalomas of the pancreas are detected with increasing frequency. This study presents results of clinical manifestations of PET and predictive factors associated with survival. METHODS: From year 1990 through 2006, medical records of 98 patients (56 men, 42 women) who were diagnosed as PET pathologically at Seoul National University Hospital were reviewed retrospectively. RESULTS: Ages ranged from 17 to 76 years (mean 51.6+/-1.3 years) with a mean follow-up of 3.6+/-0.4 years (range 0-10.1 years). Overall 5-year survival rate was 68.1%, and 5-year survival rate of the patients who had distant metastases at initial diagnosis was 43.9%. Functioning tumors [hazard ratio (HR) 0.229, 95% confidence interval (CI) 0.056-0.943, p=0.041] and lymph node or liver metastases (HR 5.537, 95% CI 2.106-14.555, p<0.001) were the significant prognostic factors associated with survival rate. However, tumor size and pathology showed no significant association with survival. CONCLUSIONS: Because small and pathologically benign nature do not predict good prognosis in PET, aggressive treatment such as curative resection would be considered initially even in the case of incidental PET.
Adenoma, Islet Cell/*diagnosis/epidemiology/*mortality ; Adolescent ; Adult ; Aged ; Combined Modality Therapy ; Female ; Follow-Up Studies ; Humans ; Liver Neoplasms/diagnosis/secondary ; Lymph Nodes/pathology ; Male ; Middle Aged ; Multivariate Analysis ; Pancreatic Neoplasms/*diagnosis/epidemiology/*mortality ; Predictive Value of Tests ; Prognosis ; Retrospective Studies ; Survival Rate ; Tomography, X-Ray Computed ; Treatment Outcome